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COVID in Nursing Homes Is Way Down, But Life Inside Remains Very Different

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Even among nursing homes crowned with the maximum government rating of five stars for overall quality, nearly half have been cited for an infection-control lapse.
 (Getty Images)

Cases of COVID-19 in California nursing homes are down 98% since the winter surge. But after a year of outbreaks, life inside these facilities has changed, perhaps permanently.

A year ago, Bethany Murray was on a call with nursing home managers on the East Coast. Their warning was stark: This virus will sneak into your building, and it will threaten your residents. Murray is now the administrator of Cedar Crest Nursing and Rehabilitation Center in Sunnyvale, where a bad outbreak came early.

"I can remember one time walking down the hallway and watching four or five nurses within the span of two to three minutes get a call from the county that they were positive," she said. "They had to leave. They had to walk out."

Even before the pandemic, nursing homes experienced a lot of staff turnover. When COVID hit, suddenly it was much harder to find people to do the work. So state officials loosened work rules, and Murray offered hazard pay.

"One of our doctors was pushing beds as we did a room change. And I'm unclogging toilets, and we had a pipe break in the COVID unit and the plumbers wouldn't come," she recalled.

Eventually hospitals started discharging people more quickly, including those who need post-operative care or rehab. These short-term residents take up about half the beds in Murray’s nursing home. She says they require isolation and testing, and usually more care and attention.

"It's a drain on resources that I don't think will go away until we as a larger community have kind of moved past COVID," Murray said.

Almost half a million nursing home residents in California have received one dose of vaccine. But many pandemic protocols, such as isolating new residents and testing everyone frequently, are still followed. And state rules now permit vaccinated residents to see visitors indoors.

"Even if we're 100% vaccinated, we're still going to have to follow these protocols ... until we're told not to, but also until we're reasonably confident that people coming in do not have COVID," Murray said. "And it's hard to say how long that's going to be."

Nearly 13,000 Californians died from COVID in nursing homes, a smaller percentage of the state’s total than the national average. Murray says she’s optimistic.

"The hospitals are starting the process of vaccinating our residents before they even get to us," she said. "We've taken care of our staff. All of our long-term residents are vaccinated. We're starting to see that light."

And Murray says if care homes are seeing the light, the rest of us can, too.

Molly Peterson

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